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Alzheimer's Disease Assessment Scale-Cognition (ADAS-cog)
Alzheimer's Disease Assessment Scale-Cognition (ADAS-cog)
Please visit this website for more information about the instrument: Alzheimer's Disease Assessment Scale-Cognition
Supplemental: Parkinson's Disease (PD)
|Short Description of Instrument||
The Alzheimer's Disease Assessment Scale- Cognition (ADAS-cog) was developed specifically to address selected aspects of cognitive function in Alzheimer's Disease (AD).
Overview: The 11-item scale is designed to address language and memory skills in AD patients. Several variants exist, including a 13-item measure and an item response theory (IRT) measure used for mild cognitive impairment (MCI). The administration takes approximately 35-45 minutes.
Languages: eProvide indicates that the scale has been translated into 81 languages as of November 2021. However, the extent to which these versions have been used, harmonized or validated is unclear.
Construct measured: Cognition (specific for: memory, language, praxis).
Generic vs. disease specific: Designed specific to Alzheimer's disease.
Means of administration: Rater administered paper and pencil. Training required.
Intended respondent (e.g., patient, caregiver, etc.): Patient.
|Scoring and Psychometric Properties||
Scoring: maximum: 70 (for 11-item version); higher = worse cognition. There are up to 25 points for language, 27 points for memory, 10 points for praxis, 8 points for orientation.
Psychometric Properties: The test is not normed and thus no adjustments are made for demographics. No unique cutoff scores are provided for Parkinson's disease dementia (PDD) or PD-MCI.
Although recommended as a cognitive outcome measure in PDD by Holden et al. (2016), the ADAS-Cog was only "suggested" for use as a cognition rating scale in PD by a Movement Disorder Society (MDS) task force (Skorvanek et al., 2018). The ADAS-Cog yields significantly different mean scores in Parkinson's disease groups with mild vs moderately severe dementia (defined per Mini-Mental State Examination (MMSE)) (Harvey et al., 2010). 4-week test-retest reliability was good: Spearman correlations were 0.652 for mild PDD and 0.714 for moderate PDD (Harvey et al 2010). PDD is more impaired than AD on language and praxis, while AD is more impaired than PDD in memory (Farlow et al., 2013). ADAS-Cog Total score is sensitive to treatment change in PD as seen in a 7-month cognitive rehabilitation program (Reuter et al., 2012) and sometimes (Weintraub et al., 2011) but not always after cholinesterase inhibitor treatment in PDD (Dubois et al., 2012).
It is not known whether ADAS-Cog is sensitive to progression to dementia, i.e., from PD to PD-MCI to PDD, but it is unlikely to be given its lack of sensitivity to change in MCI (Podhorna et al., 2016).
Strengths: A copyright-free alternative to MMSE. Brief screening, provides subdomain scores, easy to administer, supported by clinimetrics.
Weaknesses: Not often used in PD; as a screening test provides only superficial neuropsychological evidence, and not adequate to identify MCI.
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Document last updated August 2022